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UHC Complete Care PA-17 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care PA-17 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care PA-17 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care PA-17 (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Complete Care PA-17 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care PA-17 (HMO-POS C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Complete Care PA-17 (HMO-POS C-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For UHC Complete Care PA-17 (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $340.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The UHC Complete Care PA-17 (HMO-POS C-SNP) plan has a $340 deductible for prescription drugs. After meeting the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay $8.00 for preferred generic drugs at a standard pharmacy and $47.00 for standard generic drugs. For preferred brand drugs, you will pay a $100.00 copay, regardless of the pharmacy. For non-preferred drugs, you will pay 29% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The UHC Complete Care PA-17 (HMO-POS C-SNP) plan offers a range of benefits, including inpatient and outpatient services with varying copays, and no copay for many services. Emergency and primary care services have no copays, and preventive services like annual physical exams are also covered at no cost. Hearing, vision, and dental services are included, with hearing and vision exams having no copays, and dental services with no copays for preventive services. This plan also covers home health services, and skilled nursing facility services, with specific copays. Additional benefits include medical equipment, diagnostic and radiological services, and home infusion services, each with associated copays or coinsurance. The plan also covers over-the-counter items and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered by the UHC Complete Care PA-17 (HMO-POS C-SNP) plan. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, you will pay a $295 copay for days 1-6, and no copay for days 7-90. Additional days for Inpatient Hospital-Acute have no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $295, observation services with a $295 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, while outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care PA-17 (HMO-POS C-SNP) plan, but requires prior authorization. You will have a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance services are covered, with a $275 copay for both ground and air ambulance services, and no coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services are covered, with a $125 copay and no coinsurance. Urgently Needed Services are covered with a copay of $0-$55 and no coinsurance. Worldwide Emergency Services are also covered, with no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The UHC Complete Care PA-17 (HMO-POS C-SNP) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $20, and physician specialist services with a copay between $0 and $25. The plan also covers mental health specialty services and psychiatric services with varying copays depending on the type of session, podiatry services with a $25 copay, other health care professional services with a copay between $0 and $25, physical therapy and speech-language pathology services with a copay between $0 and $20, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
The UHC Complete Care PA-17 (HMO-POS C-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including fitness benefits and home and bathroom safety devices, are covered, and some services such as Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
The UHC Complete Care PA-17 (HMO-POS C-SNP) plan covers hearing exams with no copay, and routine hearing exams with no copay for 1 visit per year, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a copay between $199 and $1249 for 2 per year, and OTC hearing aids have a copay between $99 and $829 for 2 per year.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and includes coverage for contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum of $200 every two years; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance. Other dental services such as oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventative dental services have no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the UHC Complete Care PA-17 (HMO-POS C-SNP) plan and require prior authorization. The plan covers Medicare Part B Insulin Drugs with a $35 copay and a coinsurance between 0% and 20%, and covers both Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care PA-17 (HMO-POS C-SNP) plan. This benefit has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay, and prior authorization is required for Diabetic Equipment.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a copay of $40, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $200, Therapeutic Radiological Services with coinsurance up to 20%, and Outpatient X-Ray Services with a $25 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care PA-17 (HMO-POS C-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Complete Care PA-17 (HMO-POS C-SNP) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Complete Care PA-17 (HMO-POS C-SNP) plan, but require prior authorization. There is no copay for days 1-20, but there is a $203 copay for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Under the "Other Services" benefit, this plan covers Over-the-Counter (OTC) items with no copay, and a meal benefit with no copay, but requires prior authorization. Acupuncture, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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